MALCOLM GOURLIE MD (Credential# 153938) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MALCOLM GOURLIE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0016739. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 27 William F Palmer Rd, Moodus, CT 06469-1131. The current status is active.
| Licensee Name | MALCOLM GOURLIE MD |
| Credential ID | 153938 |
| Credential Number | CSP.0016739 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
27 William F Palmer Rd Moodus CT 06469-1131 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 545212 | 1.024845 | Physician/Surgeon | 1983-07-14 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 172280 | CSP.0024473 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-03-01 - 2007-02-28 | INACTIVE |
| Street Address | 27 WILLIAM F PALMER RD |
| City | MOODUS |
| State | CT |
| Zip Code | 06469-1131 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nutmeg Pharmacy Moodus LLC | 38 William F Palmer Rd, Moodus, CT 06469-1131 | Pharmacy | 2019-12-18 ~ 2020-08-31 |
| Bite Me Desserts | 28 William F Palmer Rd, Moodus, CT 06469-1131 | Bakery | 2012-09-27 ~ 2013-06-30 |
| East Haddam Volunteer Fire Department | 44 William F Palmer Rd, Moodus, CT 06469-1131 | Supplemental Responder | 2017-02-17 ~ 2017-12-31 |
| Brian J Bentley | 22 William F Palmer Rd, Moodus, CT 06469-1131 | Emergency Medical Service Instructor | 2011-06-27 ~ 2014-04-01 |
| Roger P Patterson · Patterson Home Improvement | 22 William F Palmer Rd, Moodus, CT 06469-1131 | Home Improvement Contractor | 2006-08-22 ~ 2006-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maria Cicero Barber | 82 Mott Lane, Moodus, CT 06469 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Matthew R Riley | 53 Great Hillwood Road, Moodus, CT 06469 | Real Estate Salesperson | ~ |
| Toni L Daddeo · Alden | 3 Winterbrooke Rd, Moodus, CT 06469 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Heather Congdon | 63 Falls Rd, Moodus, CT 06469 | Professional Counselor Associate | ~ |
| Fallon Elizabeth Morris | 29 White Sands Rd, Moodus, CT 06469 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Erika J Mccormack | 108 Stockburger Rd., Moodus, CT 06469 | Hairdresser/cosmetician | 2020-06-01 ~ 2022-05-31 |
| Emily K Foster | 17 Robbie Road, Moodus, CT 06469 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Nancy G O'briant | 129 Leesville Rd, Moodus, CT 06469 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Kayla Rivera | 138 Fall Road, Moodus, CT 06469 | Medication Administration Certification | 2020-06-03 ~ 2022-06-03 |
| Suzanne Kraynak | 35 Trowbrige Rd, Moodus, CT 06469 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 06469 | |||
| City | MOODUS |
| Zip Code | 06469 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MOODUS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Malcolm B Friedman | 35 Canterbury Rd., Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Malcolm L Whitman Dds | 56 George St, Mendon, MA 01756-1138 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Malcolm Gordon Md | 38 Harborview Ave, Norwalk, CT 06854 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jessica A Malcolm | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Sarah Masoodsinaki | 470 Malcolm X Blvd Apt 14m, New York, NY 10037-3034 | Controlled Substance Registration for Practitioner | 2015-07-08 ~ 2017-02-28 |
| Malcolm S Roth | 33 Saddle Ridge, Bloomfield, CT 06002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Tunesia L Mitchell | 470 Malcolm X Blvd Apt 2g, New York, NY 10037-3012 | Controlled Substance Registration for Practitioner | 2009-10-20 ~ 2011-02-28 |
| Kelly Jarrett | 380 Malcolm X Blvd, New York, NY 10027 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sikandar Z Khan | 470 Malcolm X Blvd Apt 9t, New York, NY 10037-3026 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Malcolm R Freedman | 6440 Bigelow Commons, Enfield, CT 06082 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).